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Prior to the Act of Consolidation of 1854, Bella Vista was part of the Moyamensing Township. It was sparsely settled until the 1840s and 1850s when it became an impoverished area on the outskirts of the industrializing city. The New York Tribune noted in 1848 that the districts of Moyamensing and nearby Southwark were composed of "the most graceless vagabonds and unmitigated ruffians" as well as "loafers" who were members of various gangs.[3] In addition to Irish immigrants, it was also once home to a large portion of the city's black population, many of whom were former slaves from the South. In 1852, the Institute for Colored Youth, a school (and later college) for people of African descent, was established at 10th and Bainbridge.

During the late 1800s, Italian immigrants began settling the area in large numbers, which reshaped the neighborhood's character. One of the earliest immigrants, Antonio Palumbo, opened a boardinghouse on the corner of 9th and Catharine in 1884 that became the social center of the neighborhood's growing Italian community.

The planned construction of the South Street Expressway in the 1960s led to a drop in property values in the neighborhood. Many of the neighborhood's residents subsequently fled to the suburbs. As they did in adjacent Queen Village, developers and city planners attempted to rebrand the neighborhood and began referring to it as "Bella Vista" in the early 1970s.

The city eventually scrapped plans for the second cross-town expressway. In the late 1970s, the neighborhood began to gentrify due to its proximity to Center City. In 1982, it was featured as a case study in Michael Lang's Gentrification Amid Urban Decline: Strategies for America's Older Cities. During the same era, the neighborhood also experienced an influx of Vietnamese and Mexican immigrants, especially near Washington Ave. While much of the Italian-American community has moved away, many Italian shops and restaurants still remain clustered along the market on 9th Street.

Annual festivals in the neighborhood include the Italian Market Festival and Bella Vista Festa. Arts and cultural events in Bella Vista are centered on public concerts, coffeehouses, Mew Gallery, and the Fleisher Art Memorial.

The neighborhood has a bocce league that plays at Bardascino Park (10th and Carpenter Streets) and features a permanent community garden at 10th and Kimball.